250 Years of Community Care: How We Resist Governmental Control of Our Bodies

Since the Supreme Court overturned the constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization in 2022, the anti-abortion movement has intensified efforts to restrict abortion access at the state level through legislation, litigation, and criminal investigations targeting patients, their families and friends, and their health providers.

This devastating reversal of longstanding precedent reminds us that the fight for bodily autonomy has never been a straight line of progress. Thus, we have much to learn from those who resisted state intrusion over the past 250 years, as we work to restore our rights in the years ahead.

Here, we place the current moment in historical context by examining the origins of midwifery in Native and enslaved Black communities in early America, alongside the efforts of anti-abortion advocates and the judiciary to erode reproductive rights in response to these practices. In doing so, we provide an overview of the broader implications of those efforts and their recent revival by modern conservatives. Finally, we draw lessons from the experiences of midwives and healthcare activists—who risked criminalization to care for their communities—as we consider how best to support our own communities today.

The Fight We Face Today

We have much to learn from those who resisted state intrusion over the past 250 years as we work to restore our rights in the years ahead.

Present efforts to control our bodies by controlling our access to healthcare is part of a well-funded, coordinated strategy to curtail abortion access not only in states that ban or restrict abortion, but also in states that protect reproductive rights via shield laws, which prevent out-of-state legal actions from affecting those who provide legal healthcare.

Anti-abortion advocates have sought to: (1) pressure the Donald Trump administration to further restrict access to the abortion medication mifepristone, including its distribution through telehealth; (2) enact legislation targeting health providers, as well as the family members and friends of people seeking abortion care; (3) pursue civil and criminal actions against providers operating in states under shield laws; and (4) revive a “zombie law” (in the books since 1873 but not enforced) known as the Comstock Act, which could be used to criminalize not only the mailing of abortion medication but also a broad range of medical equipment used in reproductive and obstetrical care—even in states where abortion is legal and protected.

These contemporary attacks on abortion access, and the criminalization of patients and providers, represent the latest chapter in a long history of efforts to regulate, restrict, and criminalize reproductive healthcare.

In many respects, these efforts are gaining traction. The Food and Drug Administration is currently reviewing the safety record of mifepristone, a medication used in more than half of all abortions in the United States, following bogus claims advanced by anti-abortion advocates who are increasingly frustrated that abortion care continues to be accessed by people located in anti-abortion states. At the same time, health providers face increasing threats to their professional licenses, as well as growing civil and criminal liability for providing care to patients in states where abortion is banned.

Rates of pregnancy-related criminalization have also risen since Dobbs. States such as Louisiana and Texas have brought criminal and civil actions against providers in shield-law states for their role in providing abortion care to individuals in ban states and are seeking judicial rulings that could undermine the constitutionality of shield laws. Meanwhile, anti-abortion advocates continue to press for enforcement of the Comstock Act, a 19th-century anti-vice law that prohibits the mailing of “obscene matter.” Supreme Court Justice Clarence Thomas recently signaled support for that position, writing in a dissent that he agreed with anti-abortion states arguing that Comstock remains enforceable and referring to shield law providers’ actions as a “criminal enterprise.”

These contemporary attacks on abortion access, and the criminalization of patients and providers, represent the latest chapter in a long history of efforts to regulate, restrict, and criminalize our bodies.

The Origins of Anti-Abortion and Anti-Contraception Laws

Reproductive healthcare has long been deeply embedded in many African and Indigenous cultural traditions.

Indigenous midwives and healers in states like New Mexico played a vital role in providing community-based care, sharing knowledge about contraception, pregnancy, childbirth, and reproductive wellness across generations. Before European colonization, Indigenous peoples throughout North America used plants such as black cohosh, stone seed, false hellebore, thistles, and Castilleja linariifolia to manage fertility, prevent pregnancy, and induce abortion. After European arrival, Indigenous birth workers and healers shared family-planning practices with the settlers, many of whom came from countries where herbal contraceptives, abortifacients, and other forms of reproductive healthcare were widely restricted or stigmatized.

Reproductive healthcare has long been deeply embedded in many African and Indigenous cultural traditions.

Likewise, enslaved Africans brought extensive botanical and reproductive knowledge to the Americas and used contraceptives such as cotton root and alum water to prevent or terminate pregnancies. Research suggests that enslaved people in southern United States used chili, yam, papaya, lime, and the roots and barks of cotton trees to limit their fertility and were provided with abortifacients—that is substances to induce abortions—like tansy, catnip, thyme, horse mint, rue, pennyroyal, and cedar berries by granny midwives.

These practices among enslaved Africans were acts of resistance to undermine the plantation regime, which depended on the forced reproduction of enslaved people for economic profit. Plantation doctors frequently disparaged these practices and sought to replace them with what they considered superior medical techniques developed through forced experimentation on enslaved Black women.

After slavery ended, skilled Black midwives became strong competitors to White male  gynecologists who launched a smear campaign to delegitimize midwifery practices. In addition to falsely portraying Black midwives as incompetent and midwifery practices as unscientific, White male gynecologists also leveraged their professional and political influence to push state authorities to regulate, control, and criminalize Black and Native midwifery practices and the knowledge associated with them.

In addition to the increased regulation of Native and Black birth workers, which pushed midwives out of the profession, states also began to criminalize birth control and abortion. White male gynecologists viewed abortion as contrary to what they believed was women’s proper role in society and were concerned about the growing number of White women choosing to end their pregnancies. These male physicians played an instrumental role in restricting access to and criminalizing contraception and abortion.

This wave of criminalizing legislation was advanced through anti-obscenity laws, including the Comstock Act of 1873, which modern anti-abortion activists argue should apply to the mailing of mifepristone—a safe, effective and widely used option for medication abortion.

The Legal Battle for Reproductive Autonomy

Armed with the Comstock Act, the federal government has aggressively targeted the distribution of reproductive healthcare information and those who sought to expand access to it. One of its most prominent targets was Margaret Sanger, a nurse and activist who opened the first birth control clinic in New York and challenged laws restricting contraception. In 1914, the New York City postmaster banned Sanger’s journal, The Woman Rebel, because it provided information about when and why women might seek to avoid pregnancy. She was later arrested and charged with four criminal counts for violating the Comstock Act for her publication, though these charges were eventually dropped. The New York police raided the clinic and confiscated the clinic’s contraceptive supplies.

However, the state continued to criminalize birth control activists and their efforts to care for their communities. In 1916 and 1917, at least 20 activists—including Sanger and anarchist Emma Goldman—were arrested for discussing and distributing information about birth control.

These charges and raids sent a clear message to reproductive rights activists: if you help people maintain control over their own bodies, you risk facing state repression.

Despite centuries of disembodiment, genocide, hostility, and criminalization, Indigenous and Black midwives, doulas, and birth workers resisted capitalistic exploitation of their bodies and wombs by providing women with autonomy.

In addition to the federal Comstock Act, many states enacted their own “little Comstock” laws to regulate what they considered obscene materials and practices within their borders. By the early 1960s, 47 states had enacted anti-obscenity statutes and 31 of them explicitly included contraception among the materials classified as obscene. These restrictions remained in place until the Supreme Court’s decision in Griswold v. Connecticut in 1965, which held that married couples had a constitutional right to use contraception. However, unmarried couples and minors did not gain comparable access until the 1970s.

Unfortunately, many marginalized communities continued to face barriers to reproductive healthcare even after Supreme Court rulings expanded access to contraception and abortion care in Roe v. Wade. Black and Native communities faced forced sterilization campaigns, experienced widespread healthcare discrimination leading to high infant and maternal mortality rates, and obstacles to contraception access and abortion care. While research shows that community-based models of care, such as midwifery, improve maternal and infant health outcomes, the availability of such care remains limited due to widespread licensing and regulatory requirements.

However, despite the increasing risks of criminal punishment, Black and Native birth workers, midwives, and healers continue to provide care to their communities, fight for our collective survival, and build the pregnancy and birth justice movements that sustain all communities.

Birth Justice and Collective Remembering

Despite centuries of disembodiment, genocide, hostility, and criminalization, Native and Black midwives, doulas, and birth workers resisted capitalistic exploitation of their bodies and wombs by providing women with autonomy. This labor plays an important role in helping us remember that we are embodied, interdependent, whole, autonomous, and dignified human beings—not objects to be governed. A reminder that the fertility cycle can be understood as a metaphor for the shedding of societal impositions of identity, listening to our bodies and giving ourselves grace to confront issues larger than us and greater than we can intellectually grasp. These values are reflected in the Birth Justice Framework, a human rights-centered framework developed and maintained by the Southern Birth Justice Network (SBJN) and sustained by the Black Mamas Matter Alliance, Ancient Song Doula Network, the National Black Midwives Alliance, SisterSong, and Birth Center Equity—organizations that were birthed in communities and committed to conversation, organization, and resistance.

To note, SBJN was founded by Jamarah Amani in 2008, initially for her to be a “mobile midwife” who sought to fill massive care gaps in the Black community of Overtown in Miami, Florida.  Since then, SBJN has become a national movement that trains the next generation of Black and Brown midwives and doulas, defends Black and Brown lives, and continues building on its landmark Birth Justice Framework.

The Birth Justice Framework is rooted in the recognition that LGBTQ+ and marginalized communities of color have survived a history of trauma and oppression around decisions to have or to not have children.  The framework asserts that mothers and parents have fundamental rights related to birth, including to choose whether or not to carry a pregnancy, and to choose when, where, how, and with whom to birth—including access to traditional and Native healers, such as midwives and other birth workers, and the right to breastfeeding support.

It concludes: “We know that when we, as mothers and parents, are empowered, our community is transformed.” It is therefore not simply a framework about birth but about the structures and systems that underlie a healthy society.

Although these are the very rights that anti-abortion activists have successfully curtailed over the past 40 years, Birth Justice organizers remind us that these rights are inherently already ours.

Lawfare and Our Future

While we hold these core rights as the very self-evident truths assumed in our country’s Bill of Rights, we cannot deny that many of us have never had the opportunity to enjoy them. Those who have had the least chance to enjoy these rights are now most vulnerable to their disappearance, having their rights curtailed again, as our systems of law and governance are weaponized to entrench inequality and bigotry.

In Texas, our most trusted and treasured organizational partners are under attack, and many cannot survive state aggression. Latine, Native, Black and LGBTQ+ communities have long worked to defend Birth Justice in Texas, under seemingly impossible conditions. After 18 years of working to decriminalize Black bodies, support people with HIV, and fight for birth and reproductive justice in the state, the only Black-owned reproductive justice center in North Texas, the Afiya Center has closed due to relentless pressure by state and federal actors.

Though devastating, such closures can hardly be a surprise when Texas Governor Greg Abbott and Attorney General Ken Paxton have collaborated with the Department of Justice to enforce state bounty hunter laws HB 7 and SB 8 across state borders. As “bounty hunter” laws, HB 7 and SB 8 largely rely on private citizens to report assumed violations of the law, leading to overcompliance and turning private citizens into agents of the state whose fears and prejudices have already been twisted into criminalization of care.

Simultaneously, a growing number of rural communities lack any maternal care providers at all. Since 2020, 139 rural hospital labor and delivery units have stopped delivering babies or have announced they will cease care before the end of 2026, a 13 percent reduction over five years, averaging two closures per month. Now only 41 percent of states have rural obstetric units and in six states, over a quarter of the rural maternity hospitals have stopped delivering babies. Many of these closures are in communities with large Black, Brown, and Native populations, further exacerbating our nation’s highly racialized maternal health crisis. All of this while providers are being told they must ignore racial disparities or lose federal funding entirely.

This highlights the urgent demand for supportive, culturally responsive care—and organizers are stepping up to deliver. Southern Birth Justice Center has partnered with Magnolia Birth House to build a birthing center in North Miami, where Black people are over five times as likely to die during childbirth. The center is called Olamina House after the heroine of Octavia Butler’s Parable series, with Olamina being the Yoruba word for “Wealth.” Fittingly for a place where lives are valued as the true wealth of our society, its founders sought inspiration from Afrofuturist literature, which helps us envision how to take the tapestry of human experiences, systems and practices, unwind the tangled strands, and build something strong and beautiful for the future.

Like the vision that inspired Olamina birth center, 250 years of resistance by Native healers, Black midwives, birth workers, and reproductive justice organizers reminds us that collective care is one of our most powerful tools for building a future rooted in dignity, autonomy, and liberation beyond systems that seek to control our bodies.